Coronavirus (COVID-19): Important Information From Scripps Learn more

What is Involved in Scar Revision?

Finding a plastic surgeon skilled at scar treatment is important

A person applies topical cream on a scar.

Finding a plastic surgeon skilled at scar treatment is important

After an accident, surgery or other skin injury, scar tissue can form and leave a scar that affects your appearance. A facial scar can be particularly distressing. But you don’t have to live with that scar forever. Scar revision is an option that can make a scar less noticeable.


“Scar revision is a very common procedure that can improve the condition or appearance of a scar in any part of the body,” says Salvatore Pacella, MD, a plastic surgeon at Scripps Clinic. “The goal is to make the scar as smooth and invisible as possible and make the patient more comfortable with the way he or she looks.”


If you are considering a scar revision procedure, make sure to find a qualified plastic surgeon who is skilled in scar treatment. “Your physician will evaluate your scar and discuss which types of treatments are right for you.”

Types of scars

Scars may be noticeable due to their size, shape or location. They can be raised or depressed. They may differ in color or texture from the healthy surrounding skin.

Hypertrophic scars

Hypertrophic scars are raised. They are often thick and red and form right on the wound site. They can be hyperpigmented (dark) or hypopigmented (light).

Keloids

Keloids are thick clusters of scar tissue. They grow much larger than the wound or incision that caused the scar. Keloid scarring can be painful or itchy. Keloids usually develop on the face, neck, ears, chest or shoulders. They are more common in people with dark skin.

Contractures

Contracture scars restrict movement due to skin and underlying tissue that pull together during healing. They can occur when a large area of skin is lost, such as after a burn.

Scar assessment

Treatment options vary based on the type and amount of scarring. Multiple treatments may be required. Procedures may be performed under local or general anesthesia.


“The size and type of the scar generally reflect the degree of the original injury,” Dr. Pacella says. “Other factors play a part, such as genetics and where the scar is located. Some scars may be minimal, while keloids and other thick scars can cause significant problems.”

Non-surgical and minimally invasive scar removal treatments

Topical treatments

Topical medications, such as silicone gels or silicone sheets, may be used to treat surface scars and discoloration, and to help in the healing of scar revision procedures.

Surface treatments

Surface treatment methods may be used to smooth the surface of the scar and reduce discoloration by removing the top layers of skin and allowing new skin to grow over the area. Treatment options include dermabrasion, laser or light therapy, chemical peel solutions and skin bleaching agents.

Injectable treatments

Injectable fillers made from natural ingredients or synthetic products can improve the appearance of sunken scars. Steroid injections can reduce collagen formation and alter the appearance, size and texture of raised scars.

Types of skin revision surgery

Scar revision surgery and non-surgical treatments may be done alone or in combination. Procedures vary depending on the type of scar. They may be done for cosmetic reasons or to restore function to a part of the body that is restricted by a scar or both.


With any type of procedure there are risks of complications, such as infection and bleeding. So it is important to follow your physician's direction to prevent any problems.

Skin grafts, and skin flaps

Skin grafting involves removing healthy tissue from one part of the body and attaching it over the damaged skin. Skin flaps are similar to skin grafts, but the section of skin used has its own blood supply.

Z-plasty

Z-plasty is a procedure used to revise more serious scars. A surgeon cuts along either side of the scar, and creates angled flaps that can reposition or change scar direction, interrupt scar tension and make the scar less visible.

Tissue expansion

Tissue expansion helps the body grow additional skin to cover a scar. An inflatable balloon is placed under the skin near the scar site and gradually stretches the skin. The extra skin tissue is used for the procedure.

Steps to take before scar revision

Cost is a factor in any elective surgery. Most health insurance plans will not cover scar revision surgery, so make sure to check your health plan. If you proceed, make sure your plastic surgeon is highly trained and board-certified.


“Undergoing a cosmetic procedure is very personal decision. Before deciding if scar revision is right for you, discuss the procedure with your plastic surgeon, learn what results you can achieve and explore the risks and benefits,” Dr. Pacella says.